The effects of psychotherapy on brain function: A systematic and critical review

Barsaglini, Alessio; Sartori, Giuseppe; Benetti, Stefania; Pettersson-Yeo, William; Mechelli, Andrea

doi:10.1016/j.pneurobio.2013.10.006

Cited by 145 publications

(95 citation statements)

References 108 publications

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“…The areas showing reduced activation after CBTp are known to be involved in the detection and processing of threat [36] and can be expected to change following CBTp, possibly in association with a reduction in subjective experience of threat and distress following CBTp. Interestingly, post-CBT changes in many of the areas involved in threat processing have also been seen in depression and anxiety disorders [22]. This is perhaps not surprising given that CBT across disorders [12] aims to modify appraisals of physiological, cognitive and affective states and normalise (otherwise distorted) construction of experiences.…”

Section: Fmrimentioning

confidence: 94%

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Cognitive Behaviour Therapy for Psychosis: Insights from Neuroimaging

Kumari¹,

Terca²

2017

J Neuroimaging Psychiatry Neurol

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Up to 40% of schizophrenia patients continue to suffer from distressing symptoms despite remaining compliant with their prescribed antipsychotic medication. Additional symptom reduction following cognitive behaviour therapy for psychosis (CBTp) has been shown, but only in about 50% of such patients. A clear understanding of the neural changes following CBTp (potential mediators of improvement in target outcomes) as well as neural predictors of CBTp-led improvement (possible moderators) may help to refine or develop it further and increase its effectiveness. We provide a review of studies published to date (9 in total) examining the neural effects and/or predictors of CBTp. The studies analysed comprised of one spectroscopic imaging study on pre-vs post-CBTp changes, five functional magnetic resonance imaging studies [two analysing prevs post-CBTp changes, two analysing pre-therapy brain properties as predictors of symptom reduction following CBTp, and one analysing pre-vs post-CBTp changes in functional connectivity as the predictors of long term (over 7 years) outcome following CBTp], and three structural magnetic resonance imaging studies [two on pre-therapy brain properties as predictors of symptom change following CBTp, and one analysing pre-vs post-CBTp changes]. The findings from pre-vs post-CBTp brain activation studies demonstrate that CBTp reduces fronto-limbic activation to social threat and normalises cortico-limbic functional connectivity, indicating improved affect regulation through top-down control after CBTp. Additionally, CBTp was found to reduce pituitary volume, potentially by lowering of symptom-related distress. The findings from studies analysing pre-therapy brain properties as predictors of symptom reduction following CBTp indicate that functional and structural properties of multiple brain areas that are implicated in a range of cognitive functions, particularly the dorsolateral (cognitive flexibility), medial (self-awareness) and inferior (verbal skills) frontal cortices, hippocampus (memory) and precuneus (self-awareness), predict symptom reduction following CBTp. These results suggest a role for cognitive enhancement in the context of CBTp.

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Section: Fmrimentioning

confidence: 94%

“…Although there have been recent reviews of brain changes following psychological therapies more generally [22,23], none have focused specifically on the brain correlates or predictors of CBTp effectiveness.…”

Section: Neuroimaging Predictors Of Long Term Outcome Following Cbtpmentioning

confidence: 99%

Cognitive Behaviour Therapy for Psychosis: Insights from Neuroimaging

Kumari¹,

Terca²

2017

J Neuroimaging Psychiatry Neurol

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“…Scientists believe that psychotherapy affects the functioning and structure of the brain [10]. Beck urges: 'change your mind to change your brain' [11].…”

Section: Introductionmentioning

confidence: 99%

“…Beck urges: 'change your mind to change your brain' [11]. For example, many medical imaging studies have shown that cognitive-behavioral therapies improve high and abnormal metabolism in the prefrontal cortex, anterior cingulate gyrus, and anterior nuclei in people with obsessive-compulsive disorder [10]. Moreover, it has been shown that psychotherapy improves blood circulation and abnormal activity of the prefrontal cortex, anterior cingulate cortex and amygdala in depression, post-traumatic stress, specific phobias and schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, it has been shown that psychotherapy improves blood circulation and abnormal activity of the prefrontal cortex, anterior cingulate cortex and amygdala in depression, post-traumatic stress, specific phobias and schizophrenia. In other words, studies indicate that psychotherapy optimizes brain performance in areas involved in neurocognitive functions [10,12,13].…”

Section: Introductionmentioning

confidence: 99%

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Fast Effects of Cognitive Restructuring Training on Neurocognitive Functions in Opioid Addicts

Tavakolian¹,

Abolghasemi²

2016

Arch Psych Psych

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SummaryAim: To investigate the effect of cognitive restructuring training on neurocognitive functions related to the prefrontal cortex in opioid addicts and its relationship to relapse prevention. Method:Thirty opioid addicts who completed a 21-day detoxification program were randomly placed in experimental and control groups. Before and after the training, the subjects underwent urinalysis and were tested on the Addiction-Stroop Task, Iowa Gambling Task, Wisconsin Card Sorting test and Emotion Recognition Scale.Results: Decision-making and emotion recognition were improved after the training course, but no significant difference was observed in attention bias, cognitive flexibility and relapse. Conclusions:Cognitive restructuring training and improvement of some neuropsychological functions are not enough to prevent relapse, and attention bias and cognitive flexibility should be adjusted.cognitive restructuring/neurocognitive function/addiction/relapse

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Integrating a Neuroscience Perspective Into Clinical Psychiatry Today

2017

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As psychiatrists, we are asked to treat patients with extremely complex illnesses. There are many possible ways to think about and formulate cases, including a range of psychological and social perspectives, each with their own strengths and limitations. To varying degrees, these perspectives have rightfully guided the development of our field and continue to shape the standards of our practice.During the past 20 years, revolutionary new tools and approaches in neuroscience have led to unprecedented progress in our ability to understand the biological underpinnings of psychiatric illnesses. 1 This work very much complements rather than competes with our other rich traditions. In fact, distinctions between "psychological" and "biological" are rapidly fading as evidence demonstrates that all effective treatments (whether psychotherapy or pharmacologic agents) alter core brain networks and thus are all biological in nature. 2 Cognitive neuroscience is providing contemporary neural system models for understanding psychodynamic concepts such as our sense of self, defenses and drives, and unconscious thoughts and motivations. 1 In addition, an understanding of epigenetics offers novel insights into how social context and environmental factors translate into biological changes at the level of gene expression. 3 Collectively, these advances offer a new framework for drawing together the seemingly diverse perspectives of a traditional biopsychosocial formulation. 4 They present an opportunity to create a new dialogue with our patients, their families, and other health care professionals about the cause and meaning of psychiatric symptoms. They ground psychiatric disorders and associated maladaptive behaviors in the context of a brain disease and away from issues of character and moral fiber that often drive the shame, blame, and stigma many patients face. While many of these findings have not yet translated into novel therapeutic approaches, they can still guide and inform our treatment choices. For example, understanding the role that fear conditioning and learning plays in posttraumatic stress disorder helps to clarify why trauma-focused psychotherapies are currently our most effective treatments. 5,6 Despite the relevance of neuroscience to the practice of psychiatry, figuring out how to best integrate this perspective into our field remains a challenge. 7 Psychiatry has been a well-established clinical discipline since long before we had the power to study the brain in a nuanced manner, let alone to develop sophisticated biological explanations of psychiatric illness. Accordingly, it is no surprise that such a large practice gap should exist: although mental illness is increasingly understood in terms of genetics, developmental neurobiology, and underlying neural circuitry, these essential perspectives are

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The effects of psychotherapy on brain function: A systematic and critical review

Cited by 145 publications

References 108 publications

Cognitive Behaviour Therapy for Psychosis: Insights from Neuroimaging

Cognitive Behaviour Therapy for Psychosis: Insights from Neuroimaging

Fast Effects of Cognitive Restructuring Training on Neurocognitive Functions in Opioid Addicts

Integrating a Neuroscience Perspective Into Clinical Psychiatry Today

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